MEDICARE: MS. KIMBERLY DOWD O'BRIEN APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	ARNP9369675	FL
2	363LF0000X	Family Nurse Practitioner	APRN9369675	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568970861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KIMBERLY DOWD O'BRIEN APRN

Provider Business Mailing Address
First Line	:	801 S RIO GRANDE AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32805-3799
Country	:	US
Telephone Number	:	407-835-2300
Fax Number	:	340-249-1948

Provider Business Practice Location Address
First Line	:	801 S RIO GRANDE AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32805-3799
Country	:	US
Telephone Number	:	407-716-6283
Fax Number	:	407-641-9089

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2018
Last Update Date	:	03/23/2026

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